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目的:研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及单纯鼾症的睡眠结构,探讨患者白天嗜睡等症状的原因。方法:对46例OSAHS患者(OSAHS组)、16例单纯鼾症(鼾症组)及20例正常人(对照组)进行睡眠监测,对非快速眼动(NREM)、快速眼动(REM)睡眠各期所占比例计算其百分比,并统计呼吸紊乱指数(RDI)、呼吸暂停指数(AI)、低通气指数(HI),观察OSAHS患者和单纯鼾症患者在睡眠时总的微觉醒指数(MI,次/h)、伴呼吸紊乱的MI、伴腿动的MI、伴鼾声的MI、自发性MI的差别。结果:OSAHS患者有明显的睡眠结构紊乱,其浅睡眠明显增多,深睡眠明显减少,睡眠结构不全,有明显的REM睡眠剥夺现象,醒觉时间明显延长,OSAHS患者在其仅有的浅睡眠中伴有明显多的微觉醒,并且这种微觉醒伴有明显多的腿动和(或)呼吸紊乱,OSAHS患者的自发性微觉醒也明显增多。结论:OSAHS患者睡眠时的睡眠剥夺,特别是REM期睡眠剥夺、频繁唤醒、睡眠结构紊乱及呼吸紊乱引起的减血氧而导致的脑代谢紊乱,是其白天嗜睡、乏力、记忆力减退的直接原因。
Objective: To study the sleep architecture of obstructive sleep apnea-hypopnea syndrome (OSAHS) and simple snoring and to explore the causes of the symptoms of daytime drowsiness. Methods: Forty-six patients with OSAHS (OSAHS group), 16 patients with simple snoring (snoring group) and 20 normal subjects (control group) underwent sleep monitoring. The effects of NREM, REM, The percentage of sleep stages was calculated, and the index of respiratory disorder (RDI), apnea index (AI) and hypoventilation index (HI) were calculated. The total arousal index of sleep in patients with OSAHS and simple snoring MI, times / h), MI with breathing disorders, MI with leg movement, MI with snoring, and spontaneous MI. Results: Obvious disturbance of sleep structure was found in OSAHS patients. The light sleep increased obviously, the deep sleep decreased obviously, the sleep structure was incomplete, the obvious REM sleep deprivation and the awake time obviously prolonged. OSAHS patients had only slight sleep Accompanied by significantly more arousal, and this arousal with significantly more leg movements and / or respiratory disturbances, with a significant increase in spontaneous arousals in OSAHS patients. Conclusion: Sleep deprivation in OSAHS patients, especially sleep deprivation in REM, frequent awakening, disturbance of sleep structure and cerebral oxygen metabolism disorder caused by respiratory disturbances are the direct causes of daytime sleepiness, fatigue and memory loss .